Comparison of efficacy of lung ultrasound and chest X-ray in diagnosing pulmonary edema and pleural effusion in ICU patients: A single centre, prospective, observational study

Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.

Role of Plain Abdominal X-Ray in the Differential Diagnosis of Common Acute Abdominal Conditions in Children at Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria

Background: The plain abdominal x-ray is one of the commonly requested investigations in the children emergency room, paediatric surgical ward and neonatal wards. The short interval required to carry out this investigative procedure and obtain results makes it the first imaging modality used to unravel the different causes of acute abdominal conditions in children. The safety of abdominal x-ray in children makes it attractive for use in paediatric surgical practice as part of routine work-up for undifferentiated acute abdominal conditions and also to diagnose specific causes of acute abdomen in children. Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State. Objectives: Evaluation of the role of plain abdominal x-ray in diagnosing common acute abdominal conditions in children. Materials and method: Patients admitted to the children emergency room, paediatric surgical wards, children’s ward and neonatal ward who had plain abdominal x-ray as part of their diagnostic work-up were included in the study. They were studied prospectively between March 2011 and April 2021. Results: Three Hundred and Ninety-nine patients who had plain abdominal x-rays as part of their diagnostic work-up were studied. Males were 240 while females were 159, a male to female ratio of 1.5:1. The patients were aged between 1 day to 16 years. Differential diagnoses made with plain abdominal x-ray were intestinal obstruction in 298, perforated viscus 69 patients, intra-abdominal masses 13 patients and location of intra-abdominal foreign body 14. Intestinal obstruction cases in which plain abdominal x-ray played a role in their diagnosis and management included the following: intussusception 66, neonatal sepsis 60, malrotation 48, intestinal atresia 42, anorectal malformation 32, hirschsprung’s disease in 30 cases, pyloric stenosis 24, obstructed hernia 22, post-operative adhesions 16 and intestinal helminthiasis 12. Perforated viscus accounted for 69 indications. Out of these indications, perforated gut in intussusception 19, perforated typhoid ileitis was responsible in 13 cases, gut perforation in blunt abdominal trauma 8, perforation in strangulated hernia 11 cases, perforated gut in malrotation 7, ceacal perforation in hirschsprugs disease 6 and colonic perforation in necrotizing enterocolitis 5 cases. Conclusion: Plain abdominal x-ray remains a role to play in the differential diagnosis and management of common paediatric acute abdominal conditions.

Soft X ray Diagnosis on Seed Development and Observation on Seed Germination and Seedling Growth in Artificial Hybridization in Cunninghamia and Cryptomeria

An intergeneric artificial hybridization was conducted between Cunninghamia R. Br. and Cryptomeria D.Don The results are as follows:1. A considerable number of hybrid seeds shed from 76 pollinated cones were empty and a total of 628 looks plump. Soft X ray radiographs showed that, still and all, a majority of the “plump" seeds were embryoless (597, 95.6%) whereas some were partially developed (17,2.7%) and only a few were really full (14, 2.2%). 2. Germination test showed that all of the radiographed hybrid seeds with fully developed embryos were germinable whereas those with partially developed embryos were ungerminable. 3. Physiologically, the growth rate of hypocotyl, the date for shedding of seed coat and spreading of cotyledons, the elongation of epicotyl, and the branching of shoot of the 11 month old seedlings showed a tendency to fall behind those of the female parent; morphologically, the 11 month old hybrid seedlings with linear leaves appeared rather short, slender and weak, whereas the seedlings of the female parents with linear_lanceolate leaves appeared rather tall, stout and strong. 4. It is considered that the hybrid may be true and the crossability reveals a close phylogenetic affinity of Cunninghamia with Cryptomeria.

Fast X-ray imaging beamline at SSRF

The fast X-ray imaging beamline(BL16U2)at Shanghai Synchrotron Radiation Facility(SSRF)is a new beamline that provides X-ray micro-imaging capabilities across a wide range of time scales,spanning from 100 ps toμs and ms.This beamline has been specifically designed to facilitate the investigation of a wide range of rapid phenomena,such as the deformation and failure of materials subjected to intense dynamic loads.In addition,it enables the study of high-pressure and high-speed fuel spray processes in automotive engines.The light source of this beamline is a cryogenic permanent magnet undulator(CPMU)that is cooled by liquid nitrogen.This CPMU can generate X-ray photons within an energy range of 8.7-30 keV.The beamline offers two modes of operation:monochromatic beam mode with a liquid nitrogen-cooled double-crystal monochromator(DCM)and pink beam mode with the first crystal of the DCM out of the beam path.Four X-ray imaging methods were implemented in BL16U2:single-pulse ultrafast X-ray imaging,microsecond-resolved X-ray dynamic imaging,millisecond-resolved X-ray dynamic micro-CT,and high-resolution quantitative micro-CT.Furthermore,BL16U2 is equipped with various in situ impact loading systems,such as a split Hopkinson bar system,light gas gun,and fuel spray chamber.Following the completion of the final commissioning in 2021 and subsequent trial operations in 2022,the beamline has been officially available to users from 2023.

Comparing upper gastrointestinal X-ray and endoscopy for gastric cancer diagnosis in Korea

AIM:To compare the cost and accuracy of upper gastrointestinal(GI)X-ray and upper endoscopy for diagnosis of gastric cancer using data from the 2002-2004 Korean National Cancer Screening Program(NCSP). METHODS:The study population included 1 503 646 participants in the 2002-2004 stomach cancer screening program who underwent upper GI X-ray or endoscopy.The accuracy of screening was defined as the probability of detecting gastric cancer.We calculated the probability by merging data from the NCSP and the Korea Central Cancer Registry.We estimated the direct costs of the medical examination and the tests for up- per GI X-ray,upper endoscopy,and biopsy. RESULTS:The probability of detecting gastric cancervia upper endoscopy was 2.9-fold higher than via upper GI X-ray.The unit costs of screening using upper GI X-ray and upper endoscopy were$32.67 and$34.89, respectively.In 2008,the estimated cost of identifying one case of gastric cancer was$53094.64 using upper GI X-ray and$16 900.43 using upper endoscopy.The cost to detect one case of gastric cancer was the same for upper GI X-ray and upper endoscopy at a cost ratio of 1:3.7. CONCLUSION:Upper endoscopy is slightly more costly to perform,but the cost to detect one case of gastric cancer is lower.

Exploratory Application of X-ray Photography in the Diagnosis of Poultry Fatty Liver

[Objectives]This study was conducted to explore the application value of X ray in the diagnosis of poultry fatty liver.[Methods]Serum biochemical tests were performed on laying hens with suspected fatty liver.The X-ray liver images of the left lateral position were observed.And the liver traits were observed by anatomy.[Results]The increase in liver space occupying lesion observed by X-ray photography was consistent with the increase in liver volume observed by anatomy.The biochemical test showed slight liver function abnormalities.[Conclusions]X-ray examination can be used for the auxiliary diagnosis of poultry fatty liver.

Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques

Effective prevention and management of osteoporosis would require suitable methods for population screenings and early diagnosis. Current clinicallyavailable diagnostic methods are mainly based on the use of either X-rays or ultrasound(US). All X-ray based methods provide a measure of bone mineral density(BMD), but it has been demonstrated that other structural aspects of the bone are important in determining fracture risk, such as mechanical features and elastic properties, which cannot be assessed using densitometric techniques. Among the most commonly used techniques, dual X-ray absorptiometry(DXA) is considered the current 'gold standard' for osteoporosis diagnosis and fracture risk prediction. Unfortunately, as other X-ray based techniques, DXA has specific limitations(e.g., use of ionizing radiation, large size of the equipment, high costs, limited availability) that hinder its application for population screenings and primary care diagnosis. This has resulted in an increasing interest in developing reliable pre-screening tools for osteoporosis such as quantitative ultrasound(QUS) scanners, which do not involve ionizing radiation exposure and represent a cheaper solution exploiting portable and widely available devices. Furthermore, the usefulness of QUS techniques in fracture risk prediction has been proven and, with the last developments, they are also becoming a more and more reliable approach for assessing bone quality. However, the US assessment of osteoporosis is currently used only as a pre-screening tool, requiring a subsequent diagnosis confirmation by means of a DXA evaluation. Here we illustrate the state of art in the early diagnosis of this 'silent disease' and show up recent advances for its prevention and improved management through early diagnosis.

脆性X综合征遗传学诊断方法研究进展

脆性X综合征(FXS)是导致智力障碍和发育障碍的主要单基因病之一,呈X连锁不完全显性遗传。FXS的病因是FMR1基因内(CGG)n重复序列的不稳定扩展及其上游CpG岛的异常甲基化,进而导致脆性X智力低下蛋白(FMRP)减少或缺乏,FMRP的水平直接关系到临床表型的严重程度。临床表现和基因检测是诊断FXS的主要依据。然而,FMR1基因分子结构和遗传模式的特殊性使得FXS的分子诊断和遗传咨询面临挑战。因此,如何简便而准确地进行FMR1基因检测一直是临床关注的焦点。文章针对FXS遗传学诊断方法的研究进展进行综述,旨在促进FXS的规范诊断,为临床提供帮助。

以极早发型炎性肠病为表型的婴幼儿X连锁淋巴组织增生综合征2型1例并文献复习

报道1例以极早发型炎性肠病为表型的婴幼儿X连锁淋巴组织增生综合征2型患儿的临床资料,并进行文献复习。

经阴道子宫输卵管实时三维超声造影与X线碘油造影术对女性不孕症的诊断价值

目的:探讨经阴道子宫输卵管实时三维超声造影(RT-3D-HyCoSy)与X线碘油造影术(HSG)对女性不孕症的诊断价值。方法:选取70例(140条输卵管)不孕症患者为研究对象,按照影像学检查方式不同分为对照组和观察组,每组各35例。对照组患者行HSG检查;观察组患者行RT-3D-HyCoS检查,并于检查后次月月经干净后3~7 d行腹腔镜输卵管通液术(CLP)。比较两种影像学检查方法与CLP检查结果的符合率;以CLP检查结果为“金标准”,分析HSG与3D-HyCoSy检查对不孕症的诊断价值。结果:HSG和RT-3D-HyCoSy检查与CLP结果相符合的输卵管条数分别为52条和65条,两种检查方式与CLP的符合率比较,差异有统计学意义(74.29%vs.92.86%,χ^(2)=8.792,P=0.003)。以CLP检查结果为“金标准”,RT-3D-HyCoSy检查的敏感性、阴性预测值及准确性高于HSG检查(P<0.05);两种检查的特异性、阳性预测值比较,差异无统计学意义(P>0.05)。结论:相较传统HSG,RT-3D-HyCoSy是诊断女性不孕症更有效的方法,值得临床推广。

X线诱导声学计算机断层扫描在放射检测及疾病诊断中的研究进展

X线诱导声学计算机断层扫描(XACT)是一种新兴的数字成像技术。XACT是利用单脉冲X线和超声信号的实时分析实现低辐射量和高分辨率的成像,XACT在放射检测、辐射剂量监测、肿瘤定位以及骨疾病诊断等方面具有广阔的应用前景。此外,XACT能够在单次光照时间内成像,减少辐射暴露,对临床转化具有重要意义。目前,XACT在各种医学成像领域的应用潜力已被验证,但仍需要优化成像重建算法以及提高设备临床适用性等。未来,应深入开发新的成像算法以及开展大规模临床试验,以推动其在医学成像中的广泛应用。

HUWE1基因突变合并KDM5C基因突变导致X连锁的智力障碍1例

报道1例HUWE1基因突变合并KDM5C基因突变导致X连锁的智力障碍患者的临床资料,并进行文献复习。

A Rapid Screening and Diagnosis on Fragile X Syndrome by PCR

Polymerase chain reaction (PCR) technique combined with direct detection by silver staining on denaturing DNA sequencing gel was used to analyze the (CGG)n repeats within the FMR1 gene on 169 suspected patients with mental retardation and 33 kindreds of 6 fragile X families. The results showed that : (1) No PCR products were detected in 3 males in the suspected group. (2) In the fragile X family studies, the 5 male probands failed to show any PCR products. (3) Diplex PCR with the primers flanking the FRAXE locus was used to serve as an internal control for the 8 above mentioned males and only normal products of the FRAXE locus were detected, indicating that the possibility of false negative results of the FRAXA locus could be eliminated. These findings suggested that analysis of (CGG)n repeat within the FMR1 gene by PCR technique could efficiently detect premutation carriers and that negative PCR products in mentally retarded males might highly imply the diagnosis of fragile X syndrome after the false negative results have been excluded by diplex PCR. This PCR assay is suitable for the screening and diagnosis of fragile X syndrome in a large number of populations due to its rapidity, simplicity, stability and reliability.

基于ConvNeXt模型的胸部X线图像的疾病分类与可视化

目的 胸部X线是临床实践中常见的胸部疾病筛查和诊断方式。由于放射科医生长时间阅片容易视觉疲劳以及医疗资源分配不均衡的问题,导致误诊和漏诊的情况时有发生。针对这一问题,本研究运用深度学习技术,提出了一个基于ConvNeXt模型的胸部X线图像的疾病检测方法,旨在提高胸部疾病诊断准确度、减轻误诊风险并提高医生工作效率。方法 利用大规模公开胸部X线图像数据集ChestX-ray14训练ConvNeXt模型,该模型在ResNet模型的基础上,融合了视觉Transformer结构的优势,可以有效提高模型的特征提取和识别能力,同时以AUC(ROC曲线下方的面积)作为模型性能的评价指标,与已有的分类模型CheXNet、ResNet及Swin Transformer进行了对比。此外,通过引入Grad-CAM可视化方法,利用卷积神经网络特征图的梯度信息生成胸部X线图像的类激活热力图,实现对病灶区域的定位,从而提高医生的诊断效率。结果 基于ConvNeXt模型的诊断方法在识别14种胸部疾病时平均AUC值可达0.842,特别在识别积液(AUC值为0.883)、水肿(AUC值为0.902)和疝气(AUC值为0.942)等疾病时表现较为令人满意。结论 本文提出的方法在胸部X线图像的疾病检测中具有较好的性能,是一种对胸部X线图像进行胸部疾病诊断进而协助医生提高工作效率的有益尝试。

X线平片与多层螺旋CT在髋关节病变中的应用及其骨折及关节内碎片等漏诊情况分析

目的探究X线平片、多层螺旋CT在髋关节病变诊断中的应用价值。方法选取2020年1月至2022年1月南昌大学第四附属医院放射科收治的90例髋关节病变疑似患者作为研究对象。所有患者均行X线平片和多层螺旋CT检查,比较两种检查方式对髋关节疾病的检出率、诊断效能和漏诊率。结果多层螺旋CT对髋关节病变的检出率高于X线平片,差异有统计学意义(P<0.05)。多层螺旋CT对髋关节病变的诊断灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于X线平片,差异有统计学意义(P<0.05)。多层螺旋CT对髋关节病变的漏诊率低于X线平片,差异有统计学意义(P<0.05)。结论与X线平片比较,多层螺旋CT对髋关节病变的检出率高,诊断特异性高,灵敏度强,可减少漏诊情况的发生,值得临床推广应用。

X线摄影技术在尘肺病诊断中的应用价值分析

目的:分析X线摄影技术在尘肺病诊断中的应用价值。方法:选取2022年9月-2023年5月淮南市职业病防治所诊断疑似尘肺病患者70例作为研究对象,同时进行X线摄影、高千伏摄影胸片检查,比较两组检查方法胸片质量、小阴影数量与形态、尘肺病分期诊断率。结果:X线摄影检查胸片优良率高于高千伏摄影检查,差异有统计学意义(χ2=5.833,P=0.016)。70例患者共有378个肺区,其中X线摄影、高千伏摄影检查分别检出肺区小阴影220个、198个,占比分别为58.20%、52.38%,且两种检查方式小阴影形态比较,差异无统计学意义(P>0.05)。X线摄影检出尘肺病70例,检出率为100.00%,高于高千伏摄影检出率(85.71%);在尘肺病分期上,X线摄影Ⅰ期诊断率高于高千伏摄影,差异有统计学意义(P<0.05),Ⅱ、Ⅲ期检出率比较,差异无统计学意义(P>0.05)。结论:在尘肺病的临床诊断中,X线摄影技术具有较高应用价值,可保障胸片质量,清晰地显示小阴影,提高尘肺病检出率,为治疗方案的制定提供可靠依据。

Prenatal Diagnosis of Proximal Femoral Focal Deficiency Combining Ultrasound and Computer Tomography

Four cases of proximal femoral focal deficiency (PFFD) in an otherwise healthy infant are described. Antenatal diagnosis was made at 27, 23, 23 and 18 weeks of gestation by routine ultrasound (US) examination. Computer Tomography (CT) was performed after 30 weeks of gestation and confirmed the images obtained by US. The diagnosis was confirmed after delivery. These cases illustrate the importance of combining US and CT to improve accuracy of prenatal diagnosis of skeletal disorders.

X线数字断层融合成像技术在腕骨骨折诊断和固定术后的应用价值研究

探讨X线数字断层融合成像技术(digital tomosynthesis,DTS)在腕骨骨折诊断和固定术后的应用价值。选取广东省第二人民医院2021年3月—2023年7月收治的75例腕骨骨折患者为研究对象,对75例行腕骨骨折固定术的患者分别在术后1周和两个月时行腕关节普通数字化X线摄影(digital radiography,DR)和DTS检查。结果显示,断层融合技术具有成像清晰、细节完整、价格低廉、对骨折的检出率高等优点,可有效地改善成像质量。研究发现,在腕骨骨折影像诊断中,数字断层融合技术是一种准确的方法,可应用推广。

上海光源储存环X-ray针孔相机系统设计

上海光源(SSRF)储存环X-ray针孔相机系统主要由X-ray引出前端、衰减片、小孔、靶片、相机、PXI控制器及图像采集等构成,数据采集处理软件在LabVIEW平台上开发,与控制系统的接口通过EPICS Shared Memory IOCcore技术实现。2009年8月开始的长时间在线运行证明引出前端是安全的,在300mA运行时,测量引出窗的最高温度≤36℃。该系统设计合理、性能稳定,可在线实时测量数十μm束团横向截面尺寸,从而实现3.9nm·rad发射度的测量。

INTERFACIAL BONDING IN AS DEPOSITED AND ANNEALED Co/C SOFT X RAY MULTILAYER MIRRORS

Interfacial bonding in as deposited and annealed Co/C soft X ray multilayer structures is investigated by X ray photo electron spectroscopy (XPS).It is found that there is interdiffusion between cobalt and carbon in the as deposited Co/C multilayers,and this is confirmed by structure characterization using low angle X ray diffraction (LAXD).The calculation of the chemical shifts in Co C system based on Miedemas macroscopic atom model suggests that it is impossible to detect the chemical shift experimentally in the Co C compound,which is consistent with the XPS results.The presence of metallic carbide bonding is evidenced through the nature of the carbon bonding in survey taken at Co C and C Co interfaces of annealed samples.Our results also indicate that XPS is a direct method to probe the chemical bonding at the interfaces.